1. Field of the Invention
This invention relates broadly to systems for the intravenous administration of medicaments and/or nutrients. More particularly, this invention relates to systems for distinctly identifying each of several intravenous lines used to intravenously administer medicaments and/or nutrients.
2. State of the Art
In a hospital setting patients are often administered liquid medicaments and nutrients (hereinafter collectively referred to as medicaments) via intravenous lines. Intravenous lines generally consist of flexible, plastic tubing connected at one end to an intravenous fluid source and at another end to a vasopuncture device which is inserted into a blood vessel of the patient. It is not uncommon for a plurality of intravenous lines, each connected to a different source of intravenous fluid, to be used simultaneously to deliver several medicaments at once to a single patient. It is also not uncommon for the vasopuncture devices to be located adjacent one another, e.g., in the brachial vein running through the arm.
As a result, the simultaneous use of multiple intravenous fluid lines can create a problem with the quick identification of a particular medicament source with a particular medicament output. This problem is aggravated by the tendency of each of the intravenous lines to coil (back to their packaged configuration) and consequently tangle with other lines.
Quick identification of a medicinal fluid source is often required in emergency situations. For example, when a patient hooked up to multiple intravenous lines is in need of emergency intravenous administration of a medication not currently being provided through the intravenous lines, it is necessary to immediately provide that medication. If a blood vessel cannot rapidly be located into which to inject the medication (often a problem because the most accessible vessels are already occupied with vasopuncture devices), it is common practice to provide the drug into a line in which a medication is already being administered; i.e., to "piggyback" an additional intravenous line with the exiting line. However, the person administering the drug must be sure that the line onto which the additional line is "piggybacked" is carrying a medicament which is "compatible" with the piggybacked medicament. Severe results may occur when a drug is inadvertently injected into a line in which the medicament flowing therethrough is not compatible with the injected or "piggybacked" medicament. For example, if heparin is inadvertently injected into a line through which lidocaine is already flowing, a flakey precipitate will form in the mixture which can be dangerous to a patient.
Yet, it is not an easy matter to distinguish one line from another line in the time constraints created by a medical emergency. As a result, a number of devices have been proposed to provide to health care workers systems for more rapidly identifying a medicament flowing through an intravenous line. For example, U.S. Pat. No. 5,224,674 to Simons discloses a tray having a plurality of retaining clips for linearly organizing intravenous lines, and a lid which covers the tray. Portions of the lines are placed in parallel orientation into the tray and the lid is placed over the tray. The lid is provided with spaces for labeling which medicaments flow through the lines respectively clipped beneath the labels on the lid. While providing some degree of organization to the lines, the device fails to meet current health care needs for several reasons. First, the time for setting up the device is generally not available under the cost constraints posed by managed health care. Managed health care attempts to mitigate costs; however, the device requires a relatively large amount of health care worker time to organize the lines within the tray and to label the cover with the various medicaments. Second, as health care workers are unlikely to label the tray lid until after all the lines have been inserted into the tray and the lid is placed over the lines, a potential for error is created. Lines, already tangled, may be misidentified, thereby defeating a dominant purpose of the device. Misidentifications can lead directly to patient health risk. The device, therefore, fails to alleviate another concern of managed health care, the reduction of catastrophic liability. Third, even if the health care worker properly identifies the lines, the health care worker is not able to rapidly identify the source and output of a particular line, as the worker must walk over to the tray, read a medicament label on the lid, and follow the line beneath the lid associated with the medicament label to its output. Such a procedure is inadequate for an emergency situation, where identification of a source with an output is required in a "time is of the essence" situation.
Another potential solution has been to provide a distinct appearing intravenous line between each source and its output. For example, U.S. Pat. No. 4,654,026 to Underwood discloses a plurality of transparent intravenous lines, each having distinct indicia disposed at intervals over its length and thereby providing an identification of a source with an output. U.S. Pat. No. 5,224,932 to Lappas discloses a combination of distinctly translucently colored intravenous lines and medicament reservoirs in which a line is paired with a reservoir having the same color, thereby providing a visual indication of source with output. U.S. Pat. No. 5,423,750 to Spiller discloses intravenous lines which are differently transparently colored and have a portion adjacent the output which is clear. Colored indicia matching the color of a respective line is applied to the medicament reservoir coupled to that line. While each of the above intravenous line systems provides source to output indications, there are drawbacks. First, any hospital desiring to use one of the above systems will also want to continue to use standard intravenous lines where possible (e.g., where only a single intravenous line is connected to a patient) due to the reduced cost of standard intravenous lines, and the relative expense of breaking up a set of colored lines or indicia-provided lines in order to use only a single line. Keeping the above systems and standard intravenous lines together in a hospital is both expensive and space consuming. The expense, in particular, is a concern in managed health care systems. Moreover, while providing source to output indications, the indicia and colors of the above systems when provided to translucent or transparent lines are difficult to see in low light situations. Brighter colors or more distinct indica could only be provided with opaque lines. However, it is necessary for health care workers to be able to see the fluid activity within the lines, and as a result, opaquely colored lines cannot be used.